scholarly journals MRI/US fusion prostate biopsy: Our initial experience

2016 ◽  
Vol 88 (4) ◽  
pp. 296 ◽  
Author(s):  
Vito Lacetera ◽  
Bernardo Cervelli ◽  
Antonio Cicetti ◽  
Giuliana Gabrielloni ◽  
Michele Montesi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Detection Rate ◽  
Prostate Volume ◽  
Initial Experience ◽  
Fusion Biopsy ◽  
Negative Biopsy ◽  
Group A ◽  
Group B ◽  
Target Biopsy

Aim: The objective of this study is to present our initial experience with magnetic resonance imaging/ultrasound (MRI/US) fusion biopsy using the Koelis Trinity device after the first consecutive 59 patients. Materials and methods: 59 consecutive patients with suspected prostate cancer (PCA) underwent prostate biopsy using Trinity Koelis® (Koelis, Grenoble, France). We divided the patients into 2 groups: patients with a previous negative mapping underwent to a MRI/US fusion re-biopsy (Group A); and biopsy-naïve patients who underwent to a first stereotactic 3-D mapping of the prostate (Group B). Group A (22 patients):mean age 64 years (CI 48-73), mean PSA = 7.7 ng/ml (CI 4.2- 9.9); mean prostate volume 55 ml(CI 45-82), Digital Rectal Examination (DRE) positive in 2/22, number of lesions detected by MRI 1.4, mean cores from each MRI target lesion 3 (CI 2-5), mean total cores 15 ( CI 12-19). Group B (37 patients): mean age 66 years (CI 49-77), mean PSA= 4.7 (3.2- 7.9); mean prostate volume 45 ml (33-67), DRE positive in 5/37, mean total cores 14 ( CI 10-16) Results: In Group A 10/22 patients were positive for PCA (overall detection rate of 45.5%): 6 PCA were detected by target biopsy and 4 cancer by random biopsy. Significant prostate cancer (defined as the presence of Gleason pattern 4) was detected in 4/10 patients (Significant PCA detection rate of 40%) and all significant PCA were detected by MRI target biopsy. All PCA detected by random biopsy had Gleason score 3 + 3 = 6. In Group B (biopsy naïve patients) 14/37 patients were positive for PCA (overall detection rate of 37.8%), Significant prostate cancer was detected in 5/14 patients (Significant PCA detection rate of 35,7%). No significant side effects were recorded. Conclusions: Our overall detection rate was 45.5% and 37.8% in Group A (patients with previous negative biopsy and persistent suspicion of PCA) and in Group B (biopsy naïve patients) respectively; clinical significant PCA detection rate was respectively 40% and 35.7%. These results are similar to current literature and promising for the future. We believe that using platforms of co-registered MRI/US fusion biopsy can potentially improve risk stratification and reduces understaging, undergrading and the need for repeat biopsies in biopsy naïve patients (using a stereotactic first mapping) and in patients with previous negative biopsy and persistent suspicion of PCA ( using a second MRI/US fusion biopsy).

scholarly journals PSA Density Help to Identify Patients With Elevated PSA Due to Prostate Cancer Rather Than Intraprostatic Inflammation: A Prospective Single Center Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Salvatore M. Bruno ◽  
Ugo G. Falagario ◽  
Nicola d’Altilia ◽  
Marco Recchia ◽  
Vito Mancini ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Multivariable Analysis ◽  
Binary Logistic Regression Analysis ◽  
Single Center ◽  
Negative Biopsy ◽  
Psa Density ◽  
Clinically Significant ◽  
Prostatic Inflammation

The association between PSA density, prostate cancer (PCa) and BPH is well established. The aim of the present study was to establish whether PSA density can be used as a reliable parameter to predict csPCa and to determine its optimal cutoff to exclude increased PSA levels due to intraprostatic inflammation. This is a large prospective single-center, observational study evaluating the role of PSA density in the discrimination between intraprostatic inflammation and clinically significant PCa (csPCa). Patients with PSA ≥ 4 ng/ml and/or positive digito-rectal examination (DRE) and scheduled for prostate biopsy were enrolled. Prostatic inflammation (PI) was assessed and graded using the Irani Scores. Multivariable binary logistic regression analysis was used to assess if PSA density was associated with clinically significant PCa (csPCa) rather than prostatic inflammation. A total of 1988 patients met the inclusion criteria. Any PCa and csPCa rates were 47% and 24% respectively. In the group without csPCa, patients with prostatic inflammation had a higher PSA (6.0 vs 5.0 ng/ml; p=0.0003), higher prostate volume (58 vs 52 cc; p<0.0001), were more likely to have a previous negative biopsy (29% vs 21%; p=0.0005) and a negative DRE (70% vs 65%; p=0.023) but no difference in PSA density (0.1 vs 0.11; p=0.2). Conversely in the group with csPCa, patients with prostatic inflammation had a higher prostate volume (43 vs 40 cc; p=0.007) but no difference in the other clinical parameters. At multivariable analysis adjusting for age, biopsy history, DRE and prostate volume, PSA density emerged as a strong predictor of csPCA but was not associated with prostatic inflammation. The optimal cutoffs of PSA density to diagnose csPCa and rule out the presence of prostatic inflammation in patients with an elevated PSA (>4 ng/ml) were 0.10 ng/ml2 in biopsy naïve patients and 0.15 ng/ml2 in patients with a previous negative biopsy. PSA density rather than PSA, should be used to evaluate patients at risk of prostate cancer who may need additional testing or prostate biopsy. This readily available parameter can potentially identify men who do not have PCa but have an elevated PSA secondary to benign conditions.

The validity of repeat prostate biopsy in prior biopsy negative patients: MRI-TRUS fusion guided biopsy.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 95-95
Author(s):  
Jinho Hwang ◽  
Jung Jun Kim ◽  
Jong Jin Oh ◽  
Chang Wook Jeong ◽  
Sangchul Lee ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Detection Rate ◽  
Statistical Significance ◽  
Transrectal Ultrasound ◽  
Negative Results ◽  
Guided Biopsy ◽  
Clinically Significant ◽  
Magnetic Resonance Imaging Mri ◽  
Target Biopsy

95 Background: To investigate validity of magnetic resonance imaging (MRI)-transrectal ultrasound fusion target biopsy (Fusion-Bx) compared with transrectal ultrasound-guided biopsy (TRUS-Bx) by evaluating detection rate of prostate cancer (PCa). Methods: Medical records of 376 patients with prior negative TRUS-Bx who underwent repeat prostate biopsy between Aug. 2015 and Apr. 2017 were retrospectively reviewed. The cohort was stratified into two groups (TRUS-Bx and Fusion-Bx) and clinical and biopsy characteristics patterns were analyzed. Conventional systemic randomized 12-core biopsy was performed in TRUS-Bx group whereas Fusion-Bx group applied additional 2-croes of target biopsy against suspicious lesions in MRI. Results: There were total 195 and 181 patients in TRUS-Bx and Fusion-Bx group, respectively. The overall cancer detection rate was slightly higher in Fusion-Bx group, but no statistical significance was observed (24.6% vs 28.7%, p = 0.367). Fusion-Bx group showed a significantly greater detection rate in target core analysis (5.0% vs 17.7%, p = 0.044). In confirmed positive biopsy patients, Fusion-Bx group had a higher rate of clinically significant prostate cancer (CsPCa) cases, but failed to achieve statistical significance (85.4% vs 92.3%, p = 0.271). When the patients with highly or very highly suspicious MRI (maximum image grade 4-5) findings in Fusion-Bx group was compared to the whole cohort of TRUS-Bx group, Fusion-Bx group was significantly greater in terms of overall detection rate (24.6% vs 38.0%, p = 0.017) and CsPCa detection rate (85.4% vs 97.0%, p = 0.009). Higher the target image grade, greater biopsy yield was achieved. Conclusions: For the patients who underwent repeat biopsy due to prior negative results, fusion-Bx showed better clinical significance including detection rate. A further study with a larger cohort size and prospective design is still needed to confirm the validity of Fusion-Bx.

Diagnostic Value of Different Systematic Prostate Biopsy Methods in the Detection of Prostate Cancer with Ultrasonographic Hypoechoic Lesions - A Comparative Study

2015 ◽  
Vol 95 (2) ◽  
pp. 183-188 ◽  
Author(s):  
Guang Xu ◽  
Minghua Yao ◽  
Jian Wu ◽  
Lehang Guo ◽  
Lijing Feng ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Detection Rate ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Diagnostic Value ◽  
Lesion Core ◽  
Biopsy Methods ◽  
Hypoechoic Lesion ◽  
A Prospective Study

Objective: To assess if a less extended biopsy in the transperineal approach is sufficient for detection of prostate cancer (PC) in patients with hypoechoic lesions. Methods: This was a prospective study of 167 consecutive patients with prostate hypoechoic lesion and who underwent transperineal ultrasound (TPUS)-guided 12-core and hypoechoic lesion core biopsy between January 2012 and February 2013. Results: PC was detected in 64.1% (107/167) of patients. The PC detection rate of the 12-core prostate biopsy scheme was the highest, but when including the hypoechoic lesion core, there was no difference between the 6- and 12-core schemes (all p > 0.05), irrespective of prostate volume or prostate-specific antigen levels (all p > 0.05). Conclusions: A more limited biopsy scheme could be sufficient for the detection of PC if the hypoechoic lesion is sampled.

scholarly journals The 20-core prostate biopsy as an initial strategy: impact on the detection of prostatic cancer

2013 ◽  
Vol 4 (2) ◽  
pp. 100 ◽  
Author(s):  
Mohamed Amine Jradi ◽  
Mohamed Dridi ◽  
Mourad Teyeb ◽  
Mokhtar Ould Sidi Mohamed ◽  
Ramzi Khiary ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rate ◽  
Prostate Volume ◽  
Cancer Detection Rate ◽  
Dépistage Du Cancer ◽  
Biopsy Protocol ◽  
Group 2 ◽  
Group 1

Introduction: To increase the detection rate of prostate cancer inrecent years, we examined the increase in the number of corestaken at initial prostate biopsy. We hypothesized that an increasingnumber of cores may undermine the accuracy of models predictingthe presence of prostate cancer at initial biopsy in patientssubmitted to 20-core initial biopsy.Methods: A total of 232 consecutive patients with prostatespecificantigen (PSA) between 4 and 20 ng/mL and/or abnormaldigital rectal examination (DRE) underwent 12-core prostate biopsyprotocol (group 1) or 20-core prostate biopsy protocol (group 2).The patients were divided into subgroups according to the resultsof their serum PSA and prostate volume. We evaluated the cancerdetection rate overall and in each subgroup. Clinical datawere analyzed using chi-square analysis and the unpaired t-testor 1-way ANOVA with significance considered at 0.05.Results: The 2 groups of patients were not significantly different withregard to parameters (age, abnormal DRE and serum PSA), althoughmedian prostate volume in group 1 (57.76 ± 26.94 cc) were slightergreater than in group 2. Cancer detection rate for patients submittedto 20 prostate biopsy was higher than patients submitted to 12prostate biopsy (35.2% vs. 25%, p = 0.095). Breakdown to PSAlevel showed a benefit to 20 prostate biopsy for PSA <6 ng/mL (37.1%vs. 12.9%, p = 0.005). Stratifying results by prostate volume, wefound that the improvement of cancer detection rate with 20 prostatebiopsy was significant in patients with a prostate volume greaterthan 60 cc (55% in 20 prostate biopsy vs. 11.3% p < 0.05). Morbidityrates were identical in groups 1 and 2 with no statistically significantdifference. There appeared to be no greater risk of infectionand bleeding with 20 prostate biopsy protocol.Conclusion: The 20-core biopsy protocol was more efficient thanthe 12-core biopsy protocol, especially in patients with prostatespecific antigen <6 ng/mL and prostate volume greater than 60 cc.Introduction : Pour augmenter le taux de détection du cancer de laprostate dans un avenir rapproché, nous avons examiné l’incidenced’une hausse du nombre de carottes prélevées lors de la biopsieprostatique initiale. Notre hypothèse était qu’en raison du nombreaccru de prélèvements, la biopsie à 20 carottes pouvait réduirel’exactitude des modèles de dépistage du cancer de la prostate à labiopsie initiale.Méthodologie : Au total, 232 patients consécutifs avec des tauxd’antigène prostatique spécifique (APS) situés entre 4 et 20 ng/mLet/ou des anomalies au toucher rectal ont subi une biopsie prostatiqueà 12 (groupe 1) ou à 20 carottes (groupe 2). Les patients ontété répartis en sous-groupes en fonction de leurs taux sériques d’APSet de leur volume prostatique. Nous avons évalué le taux de dépistagedu cancer de façon globale et par sous-groupes. Les données cli -niques ont été analysées par la méthode du chi carré et du test tpour échantillons non appariés ou par analyse unilatérale de lavariance (ANOVA), avec un seuil de signification de 0,05.Résultats : On n’a noté aucune différence significative entre lesdeux groupes quant aux paramètres (âge, anomalie au toucher rectalet taux sériques d’APS), malgré que le volume prostatique médianait été légèrement supérieur dans le groupe 1 (57,76 ± 26,94 mL)par rapport au groupe 2. Le taux de dépistage du cancer avec labiopsie prostatique à 20 carottes était plus élevé que le taux obtenuavec la biopsie à 12 carottes (35,2 % vs 25 %, p = 0,095). La répartitiondes patients en fonction des taux d’APS a fait ressortir unavantage pour la biopsie à 20 carottes lorsque les taux d’APS étaientinférieurs à 6 ng/mL (37,1 % vs 12,9 %, p = 0,005). La stratificationdes données selon le volume de la prostate a montré que lahausse des taux de dépistage du cancer associée à la biopsie prostatiqueà 20 carottes était significative lorsque le volume prostatiquedépassait 60 mL (55 % pour la biopsie à 20 carottes vs 11,3 %,p < 0,05). Les taux de morbidité étaient semblables dans les deuxgroupes, la différence n’étant pas significative sur le plan statistique.La biopsie prostatique à 20 carottes ne semblait pas associéeà un risque plus élevé d’infection et d’hémorragie.Conclusion : La biopsie à 20 carottes était plus efficace que la biopsieà 12 carottes, surtout chez les patients dont le taux d’APS était

scholarly journals 10-Year Experience in Performing Saturation Prostate Biopsy

2017 ◽  
Vol 57 (4) ◽  
pp. 430-437
Author(s):  
Luis Gabriel Villarraga ◽  
Jose Gustavo Ramos ◽  
José De La Hoz ◽  
Juan Guillermo Cataño Cataño
Keyword(s):  
Prostate Cancer ◽  
Regression Model ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rate ◽  
Prostate Volume ◽  
Univariate Analysis ◽  
Cancer Detection Rate ◽  
Wilcoxon Test ◽  
Prostate Cancer Detection

Objective: Identify the prostate cancer detection rate in patients in whom underwenta saturation prostate biopsy as a rebiopsy from January 2005 to February 2015 at SanIgnacio Hospital. Materials and methods: In San Ignacio hospital were performedfrom January 2005 to February 2015, 114 saturation biopsies. The investigatorsmade a univariate analysis of the variables. The association between the variable wasevaluated based on the T-test and Wilcoxon test. P < 0.05 was considered statisticallysignificant. Finally, a regression model was performed to predict significant variablesfor prostate cancer. Results: The cancer detection rate using saturation prostate biopsywas 16.7% of which 84% were categorized as significant. A mean of 19 cores wereobtained. There were statistically significant differences between patients with prostatecancer and healthy patients in the number of previous biopsies, number of samples,prostate volume and PSA density. Conclusion: Saturation prostate biopsy in our studyhas a prostate cancer detection rate of 16.7% and 84% of them were significant in thiscohort of patients.

MRI-transrectal ultrasound cognitive fusion-targeted transperineal template-guided saturation prostate biopsies in a consecutive cohort of men.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 43-43
Author(s):  
Haim Matzkin ◽  
Snir Dekalo ◽  
Nicola J Mabjeesh
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Detection Rate ◽  
Prostate Volume ◽  
Transrectal Ultrasound ◽  
Cognitive Fusion ◽  
Prostate Cancer Detection ◽  
Negative Biopsy ◽  
Psa Density ◽  
Mri Study

43 Background: MRI of the prostate may improve diagnostic accuracy of prostate cancer. Different fusion approaches with transrectal ultrasound images are employed. Objective: To determine the detection rate of prostate cancer in men undergoing transperineal template-guided saturation biopsy (TTSB) with MRI-based cognitive fusion. Methods: Between the years 2010-2015, 164 consecutive men underwent a multiple-core prostate TTSB. Univariable and multivariable logistic regression analyses were used to address the relationship between clinical TTSB parameters and prostate cancer detection rate. Covariates consisted of age, prostate-specific antigen (PSA), prostate volume, PSA density, digital rectal examination findings, existence of suspicious prostate lesions on MRI, number of previous negative biopsy sets, and number of cores taken during TTSB. Results: Mean age was 65 years and mean PSA was 14 ng/ml, mean prostate volume was 63 ml. Seventy percent of patients had at least two previous negative transrectal biopsy series and another 19% had at least one negative biopsy. One-hundred and fourteen patients (70%) underwent prostate MRI prior to the biopsy. The detection rate of prostate cancer among these patients was 46% of which 69% had Gleason score ≥ 7. Men with a suspicious lesion on MRI (n=80) had a detection rate of 50%, compared to 33% in patients with negative MRI study. On multivariate analysis, the most significant independent predictive factor was PSA density (p= 0.001). Other nearly significant parameters were suspicious MRI lesion, prostate volume and suspicious digital examination. Of note, the prostate cancer detection rate among patients with no MRI study prior to TTSB was 26%. Conclusions: Utilizing MRI cognitive fusion approach increases the detection rate of clinically significant prostate cancer (Gleason score ≥ 7). In patients with existing suspicion for prostate cancer after multiple negative standard TRUS-guided biopsies, performing TTSB after taking into consideration the findings on MRI and PSA density will increase dramatically the detection rate of significant disease.

scholarly journals SENSITIVITY AND SPECIFICITY OF PROSTATIC BIOPSY RESULT BASED ON PROSTATE VOLUME

2014 ◽  
Vol 21 (2) ◽  
Author(s):  
Joko Pitoyo ◽  
Ferry Safriadi
Keyword(s):  
Sensitivity And Specificity ◽  
Prostate Biopsy ◽  
Core Biopsy ◽  
Prostate Volume ◽  
T Test ◽  
Prostatic Biopsy ◽  
Prostate Biopsies ◽  
Specificity And Sensitivity ◽  
Group A ◽  
Group B

Objective: To compare the sensitivity and specificity of both types of prostate biopsies, between 6 core biopsy/sextant biopsy with volume based biopsy prostate. Material & method: The subjects were patients that have been performed prostate biopsy in Hasan Sadikin Hospital in 2006 – 2010. The data was divided into two groups, the group A (before 2009) 327 patients had performed 6 cores biopsy, group B (after 2009), the biopsy was performed based on prostate volume (volume < 40 cc : 8 cores, volume 40-60 cc : 10 coresand volume > 60 cc : 12 cores). Biopsy results confirmed by definitive results from surgery, then analyzed specificity and sensitivity between two groups. The analytical statistic test using unpaired T test and Levene’s test. Results: There were 654 patients divided in two groups. The data in both groups were similar based on analytical statistic test using unpaired t test (p = 0.28) and the data was in normal distribution (Levene’s test = p > 0.05). The group A, mean age 67.4 years, mean prostate volume 32.53 cc and mean PSA levels 29.89 ng/dl and at group B, mean age 66.7 years, mean prostate volume 30.89 cc and mean PSA levels 16.92 ng/dl. Volume based cores method in prostate biopsy have higher sensitivity and specificity compared with 6 core biopsy (97.5% vs 94.0%) and (92.2% vs 77.8%). Conclusion: The sensitivity and specificity of prostate biopsy was increased in volume based cores compared to 6 cores biopsy. Keywords: Prostate biopsy, volume based.

scholarly journals Kezdeti tapasztalataink az mpMR fúziós ultrahangvezérelt prosztatabiopsziával

2020 ◽  
Vol 161 (52) ◽  
pp. 2188-2194
Author(s):  
András Béla Hüttl ◽  
Dávid Ádám Korda ◽  
M. Zsuzsanna Lénárd ◽  
Attila Szendrői ◽  
Gábor Rudas ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Detection Rate ◽  
Prostate Volume ◽  
Cost Effective ◽  
Peripheral Zone ◽  
Transitional Zone ◽  
Lesion Size ◽  
Fusion Biopsy ◽  
Extraprostatic Extension ◽  
Targeted Biopsies

Összefoglaló. Bevezetés: A prosztatarák diagnosztikájában az utóbbi években paradigmaváltás történt. Az MR-vizsgálat fejlődése lehetővé tette a prosztatatumor gyanús elváltozásainak célzott mintavételét. Az mpMR fúziós biopszia pontos és költséghatékony módszer. Célkitűzés: Célkitűzésünk az volt, hogy összegezzük az mpMR fúziós biopsziák terén szerzett tapasztalatainkat. Módszer: A Semmelweis Egyetem Urológiai Klinikáján 2017 és 2019 között 40, mpMR fúziós biopsziát végeztünk a BioJet-program segítségével, transperinealis behatolásból. Az MR-vizsgálatok kiértékelése a PI-RADS v2 ajánlása szerint történt. Megvizsgáltuk, hogy a laesiók PI-RADS-besorolása, elhelyezkedése, mérete, az extraprosztatikus terjedés jeleinek megléte, a páciensek PSA-, illetve PSAD-értékei, valamint a prosztata volumene befolyásolja-e a mintavételek kimenetelét. Eredmények: A célzott mintavételek során pácienseink 80%-ánál igazolódott malignitás. PI-RADS 5. és 4. besorolású laesiók esetén a detektációs ráta 91%, illetve 85%, míg PI-RADS 3. laesióknál 20% volt. A perifériás zóna elváltozásainál szignifikánsan magasabb volt a pozitív eredmény valószínűsége, mint a tranzicionális zóna laesióinál (khi2(1) = 6,555, p = 0,010, Fisher-féle egzakt p = 0,017, V = 0,355). Az extraprosztatikus terjedés jelei és a magasabb PSAD-értékek növelték a pozitív minták valószínűségét (khi2(1) = 7,704, p = 0,006, Fisher-féle egzakt p = 0,004, V = 0,355; illetve 0,47 ± 0,50 ng/ml2 vs. 0,18 ± 0,17 ng/ml2; Z = 3,447, p<0,001), míg az elváltozások mérete nem befolyásolta a kimenetelt. A prosztatavolumen szignifikánsan magasabb volt azoknál, akiknél nem igazolódott malignitás (50,9 ± 18,8 ml vs. 119,6 ± 91,6 ml; Z = –3,505, p<0,001). Következtetések: Az elvégzett fúziós biopsziák detektációs rátája magasabb volt az irodalmi átlagnál. Eredményeink alapján a mintavételek kimenetelét befolyásolhatja az elváltozások PI-RADS-besorolása, elhelyezkedése, az extraprosztatikus terjedés, a PSAD-értékek, valamint a prosztatatérfogat. A fenti szempontok figyelembevételével kiválaszthatók azok a páciensek, akik a legtöbbet profitálhatnak a beavatkozásból. Orv Hetil. 2020; 161(52): 2188–2194. Summary. Introduction: The past decade has seen some major changes in the diagnostics of prostate cancer. Progress in MR imaging has allowed us to better visualise prostate cancer and thus perform targeted biopsies of tumour suspect lesions. mpMRI-ultrasound fusion-guided prostate biopsy is a precise and cost-effective method to diagnose prostate cancer. Objective: The purpose of this study was to summarise our results in mpMRI-ultrasound fusion biopsy between 2017 and 2019 and compare them with the findings in the current literature. Method: Between 2017 and 2019, fully 40, mpMRI-ultrasound fusion biopsies were performed transperineally using the BioJet fusion system at Semmelweis University Urology Clinic. The MRI evaluations were done in line with the PI-RADS v2 guidelines. It was analysed whether the PI-RADS score, the location of the tumour, lesion size, the signs of extraprostatic extension, PSA/PSAD density and prostate volume have an influence on the outcome of mpMRI-ultrasound fusion biopsy. Results: Prostate cancer was diagnosed in 80% of the cases during targeted biopsies. The detection rate was 91%, 85%, and 20% for PI-RADS 5, 4 and 3 lesions, respectively. The detection rate was significantly higher for lesions located at the peripheral zone compared to the ones in the transitional zone (khi2(1) = 6.555, p = 0.010, Fisher-exact p = 0.017, V = 0.355). Signs of extraprostatic extension and higher PSAD correlated with better detection rate (khi2(1) = 7.704, p = 0.006, Fisher-exact p = 0.004, V = 0.355; and 0.47 ± 0.50 ng/ml2 vs. 0.18 ± 0.17 ng/ml2; Z = 3.447, p<0.001, respectively). The size of the lesions did not influence the outcome. The analysis showed a significant correlation between large prostate volumes and negative biopsies (50.9 ± 18.8 ml vs. 119.6 ± 91.6 ml; Z= –3.505, p<0.001). Conclusions: The detection rate of prostate cancer with targeted biopsies was higher than the data found in the international literature. The PI-RADS score, the location of the tumour, MRI signs of extraprostatic extension, PSAD and prostate volume had an influence on the detection rate. Our findings may promote a better selection of the best candidates for targeted biopsies in the future. Orv Hetil. 2020; 161(52): 2188–2194.

scholarly journals Transrectal ultrasound-guided biopsy for prostate cancer detection: Systematic and/or magnetic-resonance imaging-targeted

2017 ◽  
Vol 11 (9) ◽  
pp. E330-7 ◽  
Author(s):  
Franck Bladou ◽  
Cora Fogaing ◽  
Mark Levental ◽  
Samuel Aronson ◽  
Mona Alameldin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rate ◽  
Specific Antigen ◽  
Resonance Imaging ◽  
Negative Biopsy ◽  
Clinically Significant

Introduction: Magnetic resonance imaging (MRI) is being more widely used in the detection of prostate cancer (PCa), particularly after an initial negative biopsy. In this study, we compared 12-core systematic biopsy (SYS), MRI-targeted biopsy (TAR), and the association of systematic and MRI-targeted (SYS+TAR) prostate biopsy in patients with previous biopsy and those who were biopsy-naive to evaluate the differences in terms of cancer detection and clinically significant cancer detection between the three modalities.Methods: Overall, 203 consecutive patients with suspicion of PCa were analyzed; 48.2% were biopsy-naive and 51.7% had at least one previous negative prostate biopsy. The median age was 66 years, median prostate-specific antigen (PSA) level was 7.9 ng/mL and median prostate volume was 46 mL. 38.9% had SYS, 19.2% TAR only, and 41.8% had SYS+TAR biopsy.Results: Overall, the PCa detection (PCaDR) was 63%. The SYS+TAR biopsy detected significantly more cancer than SYS and TAR only biopsies (72.9% vs. 56.9% and 53.8% respectively; p=0.03). Detection rate of clinically significant cancer (csPCaDR) was 50.7% overall; 65.8% in the SYS+TAR biopsy vs. 39.2% in the SYS and 48.7% in the TAR groups (p=0.002). In the biopsy-naive group, PCaDR and csPCaDR were significantly higher in the SYS+TAR group than in the SYS and TAR groups (p=0.01). In the repeat biopsy group, PCaDR and csPCaDR were equivalent in the TAR and SYS+TAR groups and higher than in the SYS group (p=0.001).Conclusions: TAR biopsy, when added to SYS biopsy, was associated with a higher detection rate of csPCa in biopsy-naive patients when compared to TAR and SYS only biopsies. In patients after previous negative biopsy, detection rates of csPCa were equivalent for SYS+TAR and TAR only biopsies, but higher than SYS.

scholarly journals Comparison of functional and oncological outcomes of innovative “three-port” and traditional “four-port” laparoscopic radical prostatectomy in patients with prostate cancer

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ben Xu ◽  
Si-da Cheng ◽  
Yi-ji Peng ◽  
Qian Zhang
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Laparoscopic Radical Prostatectomy ◽  
Positive Surgical Margin ◽  
Oncological Outcomes ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background To compare the functional and oncological outcomes between innovative “three-port” and traditional “four-port” laparoscopic radical prostatectomy (LRP) in patients with prostate cancer (PCa). Methods We retrospectively collected the data of PCa patients treated at our institutions from June 2012 to May 2016. According to the inclusion criteria, a total of 234 patients were included in the study, including 112 in group A (four-port) and 122 in group B (three-port). The perioperatively surgical characteristics, functional and oncological outcomes were compared between groups. Results There were no statistical differences in the baseline parameters between these two groups. Compared with group A, the operative time (OT) and estimated blood loss (EBL) were significantly less in group B. On follow-up, the rate of positive surgical margin (PSM), prostate specific antigen (PSA) biochemical recurrence and continence after LRP did not show any statistically significant difference between the groups. An identical conclusion was also received in comparison of overall survival (OS) and biochemical recurrence-free survival (BRFS) between both groups. Conclusions Innovative “three-port” LRP can significantly shorten the OT and reduce the EBL compared with the traditional “four-port” LRP. Meanwhile, it does not increase the rate of PSM and PSA biochemical recurrence. “Three-port” LRP could be popularized in the future in view of its superior surgical technique, considerably better functional outcomes and remarkable oncological control.

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